Wiki 93297/93298 with modifier 26. Medicare denying as they won't pay the code twice even with modifier 26

[eagle658]

Hello
Is anyone getting medicare denials saying they won't pay 93297 or 93298 twice even with the modifier 26 added (denying against the 93297 or 93298 with TC, we have an outside company that manages the device for the technical and they bill these codes). Since the code changes in 2024 from using G2066 to using 93297 and 93298 with the TC modifier, medicare won't pay the professional component as they are saying they will only pay the codes once even with modifiers. Anyone else having these issues with Medicare for 2024?

Thanks in advance

 

[Carmen7414]

Hello
Is anyone getting medicare denials saying they won't pay 93297 or 93298 twice even with the modifier 26 added (denying against the 93297 or 93298 with TC, we have an outside company that manages the device for the technical and they bill these codes). Since the code changes in 2024 from using G2066 to using 93297 and 93298 with the TC modifier, medicare won't pay the professional component as they are saying they will only pay the codes once even with modifiers. Anyone else having these issues with Medicare for 2024?

Thanks in advance

Yes are having this issue as well, we are being told this is only payable once. regardless of modifier placed or not. which does not make sense if the provider is billing for his/her time/interpretation and the remote company stores the data and owns the equipment, they should be able to bill for the TC component. CMS needs to clarify this. now it seems the commercial insurances are following this. it is a mess, but if you search under the fee schedule it clearly shows allowable/payable with the modifier attached. they really need to give clarity and fix this. it is causing so many issues for us. We have called and created a case letting them know of this issue.